The New Year brings a post-holiday parade of patients streaming into your office resolving to eat healthier (maybe after a little urging from you). It’s among everyone’s top New Year’s resolutions.

But by the early Spring, many grow discouraged as they find that they are unable to uphold their resolutions.

The reality is that major dietary changes are among the hardest resolutions to keep, with so many barriers to success. For many people, the biggest barriers may be the people they live with and love. Their spouses, parents and children.

“The choice of individual family members to walk a distinctly different path from the rest of the clan can pose challenging problems in family dynamics,” says Seattle-based naturopathic physician, Dr. Herb Joiner-Bey.

Feeding a “multivore” family—where each member has distinct and divergent dietary restrictions and preferences--is challenging, says Joiner-Bey. But it is doable: all you need is some “good common sense.” A little guidance and encouragement from a clinician who understands the quandaries also helps!

Some might call it multivore madness. I call it life. I’m a vegan married to an omnivore, and the daughter of a man who thinks meat and sugar are the two basic food groups. We love each other and love to eat together. It beats walking a lonely path or eating alone.

How do we make it work?

It starts with a conversation. We need to talk about what’s at stake here. Maybe it’s a medical necessity— losing weight to avoid surgery, changing diet to manage out-of-control diabetes, avoiding gluten and the bloat, inflammation, and leaky gut associated with it.

Perhaps it’s an ethical lifestyle choice—the desire to go vegetarian or vegan to eliminate animal cruelty and lighten one’s environmental impact. In other cases, the intention to change one’s diet comes from wanting to look terrific at an upcoming high school reunion.

When making dietary recommendations to your patient, it’s important to gather information about his or her family life—and how the proposed changes will likely affect family members and other loved ones. Does the patient live with people who will support or undermine their efforts to change their eating habits? Though it might not seem like a “clinical” issue, the answer to this question will have profound impact on the likely outcome.

Even in the most supportive families, change can be challenging. It’s important for you—and your patients—to anticipate this and to deal with the realities each individual will face.

Challenges may be even greater within certain cultures. My hometown of Miami has a distinctly Latin flavor. Cafecito breaks are a beloved afternoon tradition — and meat is on the menu at every meal. It’s not a coincidence the leading causes of death among Latinos are cancer and heart disease, but try telling that to a doting abuela. Many other cultural and regional eating habits can also be very challenging: going gluten-free in a pasta-loving Italian family, or becoming a vegetarian in a steak n’ potatoes household is no easy feat.

So how can you help your patients succeed, especially when they’re meeting resistance at home?

Begin by asking them how they plan to meet their goals and what eating healthier — or eating cleaner — the term of the moment — means for them. No gluten? Less processed food? Less sugar? And how much less? For my father, healthier eating means only one dessert a day. Nice try, Dad. But that may not be enough to move the needle.

When making dietary recommendations to your patient, it’s important to gather information about his or her family life—and how the proposed changes will likely affect family members and other loved ones. Does the patient live with people who will support or undermine their efforts to change their eating habits? Though it might not seem like a “clinical” issue, the answer to this question will have profound impact on the likely outcome.

Help your patients focus on the positive, on getting the outcomes they want and maybe discovering some happy surprises along the way. Changes to diet offer an opportunity to explore new cuisines, new flavors.

“Culinary herbs and spices make food exciting,” says Joiner-Bey. They add no sodium, no sugar, no calories. Just pleasure.

The most important conversations, of course, happen not in your office or any other clinical setting, but around the dinner table. Mealtime is a great opportunity for your patients to talk with their families about why they’re making different food choices.

Though you won’t be there at those discussions, you can be a valuable ally. Collaborate with your patients so instead of initiating “food fights,” they go in with clear strategies and explanations.

Victoria Moran, vegan author and lifestyle coach, and founder of the Main Street Vegan Academy keeps peace at the multivore table with a technique she calls DINE:

Dedicate — at least one night a week to a family meal.

Involve — everyone. The whole family stands to gain by your patients’ success and they can all have a part of the process, be it planning or preparing meals or researching recipes or wellness benefits on the web.

Negotiate — find points where everyone can agree. My suggestions: no special meals and no sniping. “Nobody is more zealous about a belief system than a recent convert,” warns Dr. Joiner-Bey. The food police are not welcome at the dinner table. Neither are cell phones, but that’s another article.

Entertain — This may sound like extra work, but trust me on this, inviting friends for a meal coaxes — or forces — family members into better behavior.

Anna Thomas, the Los Angeles-based James Beard Award-winning cookbook author (Love Soup, Vegan, Vegetarian, Omnivore) believes, as I do, that the solution to multivore madness starts in the kitchen.

It’s not about making a regular meal (whatever that is), and a gluten-free meal and a vegan meal. “Start with the food everyone eats,” Thomas says. “I love to start with a great grain – a risotto or tabbouleh or a formidable, hearty pilaf of farro and black rice – and build a meal around that.”

Cook up a mountain of whole grains, a bushel of beans or a big pot of soup, thick, rich and oomphy with spices and seasonal vegetables. Yes, vegetables — they’re the #1 dining trend, and you can make them the stars of the meal.

It’s an unfortunate fact that all-too-often, diets divide us, as Dr. David Katz, of Yale University’s Prevention Research Center, so aptly points out.

But that’s only if we let them. There are so many wonderful foods and flavors that everyone can enjoy. It’s a matter of finding the ones that work for your patients and their family. You can help your patients see their food choices as a means to achieving their wellness goals and as an opportunity to bring their families together. Everybody wins!

Wild Rice with Winter Greens,

Lemon, Pine Nuts & Raisins

Wild rice is actually a grass, and is naturally gluten-free. An old Sicilian trick, balancing the bitterness of winter greens with rich pine nuts and sweet raisins, yields a whole grain dish that’s fortifying, fabulous and brings the multivores together.

In a large pot, bring water or broth to boil over high heat. Add wild rice. Cover and reduce heat to low and simmer for half an hour. Turn off heat; leave the pot on the burner for another half hour or so, until all the liquid is absorbed. (May be done the day ahead. Cover and refrigerate. Bring back to room temperature before proceeding.)

In a large skillet, heat oil over medium-high heat. Add chopped onion and sauté stirring until it softens, about 5 minutes. Add chopped winter greens, which will shrink in the heat to a fraction of their volume. Continue cooking until greens are just wilted — another 3 to 5 minutes.

Tip in cooked rice and stir mixture gently to combine. Grate in the zest of both lemons, squeeze in lemon juice, stir in sea salt and pepper flakes. Add pine nuts and raisins just before serving.

Serves 4 to 6.

END

Ellen Kanner is the author of the award-winning book, Feeding the Hungry Ghost: Life, Faith and What to Eat for Dinner (VegNews’ 2013 Book of the Year and PETA’s Book of the Month Club debut pick). She is also Huffington Post's Meatless Monday blogger, the Miami Herald syndicated columnist Edgy Veggie, and contributor to print and online publications including: Bon Appetit, Eating Well, VegNews, Salon, Every Day with Rachael Ray and PETA Prime.

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